Rectal bleeding evaluation

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Rectal bleeding evaluation

Symptom reported by patient
 Recommended procedure
 Future screening protocol
Bright red rectal bleeding on tissue, in bowl, or on stool
 Age 50 and up:
  • Colonoscopy or flexible sigmoidoscopy with double-contrast barium enema
Age 40-50:
  • If obvious anorectal disease and no risk factors: flexible sigmoidoscopy.
  • Otherwise: colonoscopy or flexible sigmoidoscopy with double contrast barium enema
Below age 40:
  • If obvious anal source and no risk factors: treat symptomatically
  • If recurrent symptoms, then flexible sigmoidoscopy
  • Further testing if clinically indicated
 Reassess risk status based upon results of colonic exam and follow appropriate future screening protocol
Burgundy blood marbled into stool
 Colonoscopy
 Reassess risk status based upon results of colonic exam and follow appropriate future screening protocol